Bridge LMS - Course Registration

Breastfeeding Educator Course Registration
Electronic Version of Form: http://events.oucpm.org/wiceducator/
Original Form Last Updated On: 01/30/2012
For questions, please contact the OUCPM Helpdesk at (405) 325-6257. Page 1
WIC Registration
The course registration deadline is March 22nd. After March 22, please contact Rosanne Smith at
(405) 271-4676 Ext. 50014 to see if space is available. Please complete the following form. Fields marked with * are required.
First Name *
Last Name *
Phone *
Email Address *
Registrant Type
Non-WIC Health Professional OSDH Employee WIC Employee
Special Accommodations:
The Center for Public Management is committed to making reasonable accommodations so that our activities are accessible to persons with disabilities or special needs. If you need an accommodation (i.e., sign language interpreter, Braille, etc.), this can be made available upon advance request. Please contact Marley Harris at (405) 325-0451 as soon as possible to make arrangements. If you are deaf, hard of hearing, or speech impaired you may dial 711 and an operator will serve as a voice/text interpreter when contacting the event coordinator at the number listed above.

Click tabs to swap between content that is broken into logical sections.

Breastfeeding Educator Course Registration
Electronic Version of Form: http://events.oucpm.org/wiceducator/
Original Form Last Updated On: 01/30/2012
For questions, please contact the OUCPM Helpdesk at (405) 325-6257. Page 1
WIC Registration
The course registration deadline is March 22nd. After March 22, please contact Rosanne Smith at
(405) 271-4676 Ext. 50014 to see if space is available. Please complete the following form. Fields marked with * are required.
First Name *
Last Name *
Phone *
Email Address *
Registrant Type
Non-WIC Health Professional OSDH Employee WIC Employee
Special Accommodations:
The Center for Public Management is committed to making reasonable accommodations so that our activities are accessible to persons with disabilities or special needs. If you need an accommodation (i.e., sign language interpreter, Braille, etc.), this can be made available upon advance request. Please contact Marley Harris at (405) 325-0451 as soon as possible to make arrangements. If you are deaf, hard of hearing, or speech impaired you may dial 711 and an operator will serve as a voice/text interpreter when contacting the event coordinator at the number listed above.